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Safety and efficacy of percutaneous femoral artery access followed by Mynx closure in cerebral neurovascular procedures: a single center analysis
  1. Ramesh Grandhi1,
  2. Hilal Kanaan2,
  3. Aalap Shah3,
  4. Gillian Harrison4,
  5. Christopher Bonfield1,
  6. Tudor Jovin1,5,
  7. Brian Jankowitz1,
  8. Michael Horowitz6
  1. 1Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  2. 2Department of Neurosurgery, East Carolina University, Greenville, North Carolina, USA
  3. 3Department of Anesthesiology, University of Washington Affiliated Hospitals, Seattle, Washington, USA
  4. 4Department of Neurological Surgery, New York University Langone Medical Center, New York, New York, USA
  5. 5Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  6. 6Pennsylvania Brain and Spine Institute, Mars, Pennsylvania, USA
  1. Correspondence to Dr T Jovin, Department of Neurology, University of Pittsburgh Medical Center, Suite C-400, 200 Lothrop St, Pittsburgh, PA 15213, USA; jovintg{at}upmc.edu

Abstract

Background and purpose Percutaneous transfemoral arterial procedures rely on a variety of vascular closure methods. We studied closure success and complications after using the Mynx vascular closure device in cerebral neurovascular procedures.

Methods We prospectively analyzed patients undergoing diagnostic cerebral angiogram or neurointervention with arteriotomy closure using the Mynx device. Patient demographics and procedural factors were recorded. Statistical analyses compared groups and identified predictors of device failure and complication.

Results A total of 766 patients, 59% women, mean age 55.5 years (SD 14.2), mean body mass index (BMI) 29.1 kg/m2 (SD 7.4), underwent 937 neurovascular procedures in a 10 month period. Device success was achieved in 92% of patients; lower BMI, higher number of antithrombotic medications, larger sheath size, and performance of a neurointerventional procedure predicted Mynx failure. Complications occurred in 2.45% of procedures, with older age, lower BMI, higher number of antithrombotic medicines used, higher international normalized ratio, lower platelet count, and Mynx device failure conferring an increased risk of complication.

Conclusions The Mynx device is safe and effective for cerebral neurovascular procedures. However, specific patient populations may warrant particular attention and thorough consideration of risks and benefits prior to employing the Mynx device for femoral arteriotomy closure.

  • Angiography
  • Artery
  • Complication
  • Device
  • Intervention

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